Provider Demographics
NPI:1811230782
Name:HORIZON HOUSE ASSISTED LIVING INC.
Entity Type:Organization
Organization Name:HORIZON HOUSE ASSISTED LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GEORGES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-626-6672
Mailing Address - Street 1:119 W SUWANNEE LN
Mailing Address - Street 2:
Mailing Address - City:COCOA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32931-3649
Mailing Address - Country:US
Mailing Address - Phone:321-626-6672
Mailing Address - Fax:
Practice Address - Street 1:119 W SUWANNEE LN
Practice Address - Street 2:
Practice Address - City:COCOA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32931-3649
Practice Address - Country:US
Practice Address - Phone:321-626-6672
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-29
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL11605310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility